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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleMolecular Neuroimaging/Nuclear Medicine

Accuracy and Longitudinal Consistency of PET/MR Attenuation Correction in Amyloid PET Imaging amid Software and Hardware Upgrades

Chunwei Ying, Yasheng Chen, Yan Yan, Shaney Flores, Richard Laforest, Tammie L.S. Benzinger and Hongyu An
American Journal of Neuroradiology March 2025, 46 (3) 635-642; DOI: https://doi.org/10.3174/ajnr.A8490
Chunwei Ying
aFrom the Mallinckrodt Institute of Radiology (C.Y., S.F., R.L., T.L.S.B., H.U.), Washington University School of Medicine, St. Louis, Missouri
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  • ORCID record for Chunwei Ying
Yasheng Chen
bDepartment of Neurology (Y.C., H.A.), Washington University School of Medicine, St. Louis, Missouri
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Yan Yan
cDepartment of Surgery (Y.Y., T.L.S.B.), Washington University School of Medicine, St. Louis, Missouri
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Shaney Flores
aFrom the Mallinckrodt Institute of Radiology (C.Y., S.F., R.L., T.L.S.B., H.U.), Washington University School of Medicine, St. Louis, Missouri
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Richard Laforest
aFrom the Mallinckrodt Institute of Radiology (C.Y., S.F., R.L., T.L.S.B., H.U.), Washington University School of Medicine, St. Louis, Missouri
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Tammie L.S. Benzinger
aFrom the Mallinckrodt Institute of Radiology (C.Y., S.F., R.L., T.L.S.B., H.U.), Washington University School of Medicine, St. Louis, Missouri
dKnight Alzheimer Disease Research Center (T.L.S.B.), Washington University School of Medicine, St. Louis, Missouri
eDepartment of Neurosurgery (T.L.S.B.), Washington University School of Medicine, St. Louis, Missouri
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Hongyu An
aFrom the Mallinckrodt Institute of Radiology (C.Y., S.F., R.L., T.L.S.B., H.U.), Washington University School of Medicine, St. Louis, Missouri
bDepartment of Neurology (Y.C., H.A.), Washington University School of Medicine, St. Louis, Missouri
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  • FIG 1.
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    FIG 1.

    Dixon in-phase MR images (first column), DL-Dixon pCT images (second column), CT images (third column), and HU difference map between pCT and CT (fourth column) from 3 representative participants. The PET/MR scans were acquired by using the VB20P software version and a 16-channel head/neck coil (first row), the VE11P software version and a 16-channel head/neck coil (second row), and the VE11P software version and a 32-channel head coil (third row).

  • FIG 2.
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    FIG 2.

    PET reconstructed with the DL-Dixon AC (first column) or the CT AC (second column) from 3 representative participants. The PET/MR scans were acquired by using the VB20P software version and a 16-channel head/neck coil (first row), the VE11P software version and a 16-channel head/neck coil (second row), and the VE11P software version and a 32-channel head coil (third row).

  • FIG 3.
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    FIG 3.

    Mean (A) and SD (B) of PET relative error on the voxel basis across testing participants of the VB20P-16Ch model (n = 89), the VE11P-16Ch model (n = 52), and the VE11P-32Ch model (n = 24). The CT AC method is used as the reference.

  • FIG 4.
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    FIG 4.

    Cumulative voxelwise PET MRAE by using DL-Dixon AC. The acquired CT AC method is used as the standard reference. Each blue curve represents 1 participant. If the line stayed within the green region, the participant passed the qualification criteria.

  • FIG 5.
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    FIG 5.

    PET MRAE in 7 cerebral cortical and cerebellum ROIs. The boxplots show the 25th, 50th (median), and 75th percentiles. FC = frontal cortical region; APCC = anterior and posterior cingulate cortical region; LPC = lateral parietal cortical region; LTC = lateral temporal cortical region; MTL = medial temporal lobe; CTX = cortical summary region; WC = whole cerebellum region.

  • FIG 6.
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    FIG 6.

    Longitudinal consistency of PET by using CT and DL-Dixon AC. The Bland-Altman plots of the PET SUVR difference between 2 CT (A) and 2 DL-Dixon (B) ACs in the cortical summary region are shown. The red horizontal line, dotted black horizontal lines, and solid black horizontal lines represent the mean, ± SD, and ±1.96 SD of the PET SUVR differences, respectively. Scatterplots of the PET SUVR between 2 CT (C) and 2 DL-Dixon (D) ACs in the cortical summary region are shown. The solid blue line and dotted black line represent the linear fitting line and line of identity, respectively. Symbol colors indicate different tracers (blue symbols: 18F-florbetapir PET, red symbols: 11C-PiB PET).

  • FIG 7.
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    FIG 7.

    Number of participants required to detect longitudinal change in the cortical summary region with 80% power. The r is the assumed correlation between the paired measures from a participant.

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    Table 1:

    Three DL-Dixon models were trained based on the software and coil used

    n = 32916-Channel Coil32-Channel Coil
    VE20PVB20P-16Ch (n = 176)—
    VE11PVE11P-16Ch (n = 105)VE11P-32Ch (n = 48)
    • Note: The total number of participants for each model is summarized.

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    Table 2:

    The longitudinal consistency of DL-Dixon was evaluated in 38 participants with repeated scans over approximately 3 years

    n = 38Visit 2
    VB20P 16-Channel CoilVE11P 16-Channel CoilVE11P 32-Channel Coil
    Visit 1VB20P 16-channel coil10154
    VE11P 16-channel coil——9
    • Note: The software version and head coil used during the 2 visits are summarized.

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    Table 3:

    PET SUVR longitudinal consistency of CT AC and DL-Dixon AC in the cortical summary region

    CTDL-Dixon
    SUVR difference (Mean ± SD)−0.16% ± 0.74%0.25% ± 0.75%
    wCV0.53%0.55%
    ICC1.001.00
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American Journal of Neuroradiology: 46 (3)
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Vol. 46, Issue 3
1 Mar 2025
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Cite this article
Chunwei Ying, Yasheng Chen, Yan Yan, Shaney Flores, Richard Laforest, Tammie L.S. Benzinger, Hongyu An
Accuracy and Longitudinal Consistency of PET/MR Attenuation Correction in Amyloid PET Imaging amid Software and Hardware Upgrades
American Journal of Neuroradiology Mar 2025, 46 (3) 635-642; DOI: 10.3174/ajnr.A8490

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PET/MR AC Accuracy in Amyloid Imaging
Chunwei Ying, Yasheng Chen, Yan Yan, Shaney Flores, Richard Laforest, Tammie L.S. Benzinger, Hongyu An
American Journal of Neuroradiology Mar 2025, 46 (3) 635-642; DOI: 10.3174/ajnr.A8490
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